Provider Demographics
NPI:1275946964
Name:MORRIS, JAMES ERNEST JR (FNP)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:ERNEST
Last Name:MORRIS
Suffix:JR
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:548 ROSEMARY RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:MS
Mailing Address - Zip Code:38732-2075
Mailing Address - Country:US
Mailing Address - Phone:662-843-7373
Mailing Address - Fax:
Practice Address - Street 1:548 ROSEMARY RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:MS
Practice Address - Zip Code:38732-2075
Practice Address - Country:US
Practice Address - Phone:662-843-7373
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-10
Last Update Date:2021-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA218275363LF0000X
MSR890572363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS1334277Medicaid
MS1334277Medicaid